All You Need to Know About Perimenopause

Perimenopause is a natural biological process that marks the transition towards menopause and can start in a woman's 40s, although it can begin earlier or later, depending on several factors.

This guide will explore everything you need to know about perimenopause, including its symptoms, causes, and management options. A deeper understanding of this stage in life can enable women to gain more autonomy over their health.

What Is Perimenopause?

Perimenopause is a transitional phase between a woman's reproductive years and menopause. It generally begins years before menopause.

During this stage, a woman's body begins to reduce oestrogen and progesterone production, which can lead to changes in her menstrual cycle, causing it to become irregular. Other symptoms include night sweats, sleep difficulties, hot flashes, and mood swings.

What Is the Difference Between Perimenopause and Menopause?

Menopause is a natural occurrence marked by the cessation of egg production in a woman's ovaries and a gradual decline in the production of female hormones, namely oestrogen and progesterone. A woman is regarded as having reached menopause once she has gone without menstruating for 12 months consecutively.

On the other hand, perimenopause is the period before menopause when a woman's body is transitioning to menopause.

When Does Perimenopause Start?

Perimenopause can start any time during a woman's 40s, although it can occur as early as a woman's mid-30s. 

If menopause occurs before age 40, it is called premature or early menopause. This early transition can be attributed to illness or medical treatments.

How Long Does Perimenopause Last?

Perimenopause can last for several years, with the average duration being around 4 years. However, some may experience perimenopause for as little as a few months or as long as 10 years.

Once a woman has not had periods for over a year, she has formally entered menopause.

What Are the Symptoms of Perimenopause?

The symptoms of perimenopause can vary amongst women and can range from mild to severe. Some women may experience only a few symptoms, while others may experience a wide range of symptoms. Here are some common ones:

1. Irregular periods:

   Menstrual periods may become irregular, with changes in cycle length and flow.

2. Hot flashes and night sweats:

   Sudden and intense sensations of body heat, often accompanied by sweating and flushing that last 5 to 10 minutes, can occur.

3. Mood changes:

   Mood changes are common during perimenopause, including mood swings, irritability, and depression. These changes may be related to the hormonal fluctuations that occur during perimenopause.

4. Difficulty sleeping:

   Many women experience sleep disturbances due to hormonal fluctuations. These disturbances may also be related to hot flashes and night sweats.

5. Vaginal dryness:

   Reduction in oestrogen may lead to vaginal tissues losing their elasticity and lubrication. This can cause pain during sex, leading to a decline in sexual desire in midlife.

6. Decreased fertility:

   Fertility levels naturally decrease during perimenopause, but pregnancy is not impossible.

When Should I See a Doctor?

While perimenopause symptoms can be uncomfortable, they are usually not a cause for concern. However, women should seek medical attention if their symptoms are severe or make it difficult to carry out daily tasks.

Some signs that you should seek medical advice include the following:

• Period blood clots.
• Irregular spotting between cycles.
• Bleeding after sex.
• Mood changes disrupt your ability to work.

How Is Perimenopause Managed?

Every woman's experience is unique. However, several options may help alleviate the discomfort due to perimenopause.

• Hormone therapy: They can reduce perimenopausal symptoms such as hot flashes, mood changes and irregular periods.
• Vaginal lubricants and moisturisers: Can be used to reduce vaginal dryness and discomfort during sexual intercourse. Opt for water-based alternatives to minimise the risk of irritation. 
• Healthy eating: A healthy diet can help manage weight gain and other symptoms of perimenopause, including a higher risk of osteoporosis and heart disease. Eat a diet low in fat and rich in calcium and fibre (i.e. fruits, vegetables, whole grains). Avoid processed foods, sugary drinks, and excessive amounts of alcohol.
• Exercise: Regular exercise can help manage weight gain and improve mood and sleep quality. Try to get at least 30 minutes of moderate exercise daily, such as brisk walking, cycling, or swimming. However, avoid working out right before bedtime. In older women, exercising regularly aids bone growth, improving bone density and reducing the risk of hip fractures. 
• Get adequate rest: A healthy sleep routine is vital and should ideally be at least 7-8 hours per night. Avoid screens before bedtime, create a quiet and relaxing environment at night, and avoid caffeine or alcohol before bed.
• Managing stress levels: Engaging in stress-reducing techniques can smoothen the transition into menopause and improve overall well-being. Some methods to try are yoga, meditation, deep breathing exercises, and mindfulness.

Can I Get Pregnant If I Am in Perimenopause?

While it is possible to become pregnant during perimenopause, it becomes increasingly tricky as hormone levels fluctuate and ovulation becomes less frequent. Women who wish to avoid pregnancy should continue to use contraception until they have gone 12 consecutive months without a period.

Make an Appointment at Pantai Hospitals

Perimenopause is a normal and natural stage of life that marks the transition from reproductive years to menopause. While the symptoms can be uncomfortable, a combination of medical and lifestyle treatments can help manage them. 

Talk to your doctor about the symptoms and work together to develop a personalised treatment plan. With the proper care, women can successfully navigate perimenopause and enjoy optimal health and wellness.

Get in touch with us to book an appointment with our team of gynaecologists today, or find out more about our Obstetrics and Gynaecology Services at your nearest Pantai Hospital.

Pantai Hospitals have been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.